Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $416.87 / $758.58	Facility	26	$181.97	$416.87	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $1,548.82	Professional		$251.19	$426.58	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $263.03	Professional	26	$70.79	$120.23	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $288.40 / $562.34	Professional	TC	$181.97	$288.40	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $66.07 / $69.18	Professional	26	$54.95	$66.07	$69.18
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $38.90 / $38.90	Facility	26	$38.90	$38.90	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $501.19 / $870.96	Professional		$239.88	$501.19	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $81.28 / $147.91	Professional	26	$50.12	$81.28	$147.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $416.87 / $776.25	Professional	TC	$173.78	$416.87	$776.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $346.74 / $1,148.15	Professional		$295.12	$346.74	$1,148.15
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $93.33 / $1,148.15	Professional	26	$81.28	$93.33	$1,148.15
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $257.04 / $1,148.15	Professional	TC	$213.80	$257.04	$1,148.15
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $281.84 / $707.95	Professional		$229.09	$281.84	$707.95
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $72.44 / $109.65	Professional	26	$61.66	$72.44	$109.65
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $208.93 / $616.60	Professional	TC	$177.83	$208.93	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $371.54 / $707.95	Professional		$190.55	$371.54	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $72.44 / $134.90	Professional	26	$46.77	$72.44	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $275.42 / $616.60	Professional	TC	$134.90	$275.42	$616.60